Camptocormia.
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Adaptation, Psychological↗
Biomedical subjects
R E Eilert
Publications and source records attributed to R E Eilert.
Primary aneurysmal bone cysts: 16q22 and/or 17p13 chromosome abnormalities.
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Adolescent↗
Hip subluxation in cerebral palsy: what should be done for the spastic child with hip subluxation?
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Cerebral Palsy↗
Congenital pseudarthrosis of the ulna: a report of two cases and a review of the literature.
Two cases of congenital pseudarthrosis of the ulna in patients with neurofibromatosis were followed up for 15 and 8 years, respectively. In both cases conventional bone grafting failed. The solution in one case was production of a one-bone forearm. In the other, osteotomy of the radius, resection of the ulnar pseudarthrosis, and stabilization of the distal radioulnar joint achieved a good result. The literature suggests that free vascularized bone grafting, electrical stimulation, formation of a one-bone forearm, or osteotomy of the uninvolved bone with or without resection of the pseudarthrosis should be considered as treatment alternatives.
Adolescent↗
Operative lengthening of the lower extremity and associated psychological aspects: the Children's Hospital experience.
Twenty-two patients underwent 23 femoral and tibial lengthenings by the Wagner technique from 1977 to 1987. Average length gained was 5.8 and 5.2 cm, respectively. Long hospitalization in addition to multiple operative procedures and a high complication rate created a significant psychological impact. Fourteen of 22 patients experienced psychological problems, primarily adjustment disorders, all of which resolved without long-term sequelae. Parental/family and nursing staff support were identified as the most important during the lengthening process. Advances in limb lengthening techniques may lessen the overall impact of this procedure, but preoperative psychological preparation is important.
Adolescent↗
Intraoperative blood salvage in children and young adults undergoing spinal surgery with predeposited autologous blood: efficacy and cost effectiveness.
We conducted a retrospective review of 155 spinal operations at our institution to determine the efficacy of intraoperative salvage. Addition of intraoperative salvage had little effect on the success of a preoperative autologous donation program. Only patients with operative blood loss > 2,000 ml (12% of patients) benefited from this expensive source of autologous blood. The technique tended to be most effective in children aged 16-18 years. Use of intraoperative salvage for all pediatric spinal procedures is neither necessary nor cost effective.
Adolescent↗
Osteogenic sarcoma arising from bony regenerate following Ilizarov femoral lengthening through fibrous dysplasia.
Sarcomatous degeneration of fibrous dysplasia has been previously documented in rare cases, often in association with prior radiation therapy. This case report describes the occurrence of osteosarcoma arising in the distal femur of a 15-year-old male with previous biopsy-proven fibrous dysplasia, who had undergone limb lengthening through a distal femoral corticotomy using the technique described by Ilizarov. In addition, distraction osteogenesis through an area of fibrous dysplasia in the proximal tibia produced a new area of fibrous dysplasia in the regenerate tissue as shown by histopathologic examination. This case raises two questions: (a) whether the biologic stimulus of distraction osteogenesis through abnormal metaplastic bone increases the risk of malignant neoplasia, and (b) whether distraction osteogenesis through dysplastic bone is contraindicated, since the regenerate tissue does not form normal bone.
Bone Lengthening↗
The success of closed reduction in the treatment of complex developmental dislocation of the hip.
The purpose of our study was to determine the efficacy of closed reduction in the treatment of complex developmental dislocation of the hip. We identified two factors, the cone of stability and the limbus type, through the use of arthrography and gentle examination under anesthesia, which are useful guidelines in the management of complex developmental dislocation of the hip. We feel as a result of this study we can select those cases of complex developmental dislocation of the hip that are amenable to closed reduction and separate them from those other cases for which we recommend open reduction.
Arthrography↗
Cavus foot in cerebral palsy.
In the child between 4 and 12 years of age presenting with cavus deformity associated with spastic cerebral palsy, symptomatic feet may be improved by soft tissue release of plantar structures followed by appropriate tendon lengthenings or transfers and good cast correction. It is more common for the deformity to present in teenage patients, however, with a more rigid foot usually complicated by some degree of varus and equinus. In these situations, triple arthrodesis is often necessary and is a predictable procedure for correction and stabilization of the deformity.
Adolescent↗
Fluoroscopic technique versus Phemister technique for epiphysiodesis.
Seventy patients were followed after epiphysiodesis for limb length discrepancy. The Phemister technique was used on 44 and the fluoroscopic technique on 26 patients. Both techniques achieved growth plate arrest in 100% of patients. The average hospital stay was 1.8 days for the fluoroscopic technique and 3.5 days for the Phemister technique. Of the Phemister technique patients, 40% required formal postoperative physical therapy compared to only 8% of the fluoroscopic technique patients. The complication rate was two of 44 (4.5%) for the Phemister technique and one of 26 (4%) for the fluoroscopic technique. The advantages of the fluoroscopic technique are a much smaller scar, less postoperative knee stiffness, and a shorter hospital stay. Because of the similar results, the fluoroscopic technique is recommended.
Adolescent↗
Fibular transfer for congenital absence of the tibia.
In patients with congenital absence of the tibia, construction of a knee joint by transferring the fibula under the femoral condyle gives satisfactory results, provided a strong quadriceps is present. In the rare patient with an associated proximal focal femoral deficiency on the same side, even in the absence of a strong quadriceps, this procedure with a fibulofemoral fusion will give a longer stump, allowing better prosthetic fitting. The procedure is performed as early as the first year of life.
Arthroplasty↗
Bone and soft tissue sarcomas in children.
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Adolescent↗
Effect of chemotherapy on human growth plate.
Histologic specimens of the distal femoral growth plates of 10 patients treated surgically for osteosarcoma were examined retrospectively. Eight of the patients received preoperative chemotherapy. None of the specimens showed complete growth arrest. The gross thickness of the plates was preserved. Columnar arrangement of the cells was minimally disrupted. The number of proliferative cells in each column was decreased, and the number of hypertrophic cells, was increased slightly. The metaphysis showed longitudinal trabeculations with a high chondroid content. Growth arrest lines were evidenced by transverse trabeculations with a high osteoid content. Our findings provide histologic support for previous clinical studies. Absence of complete growth arrest and evidence of a resumption of growth are relevant in planning limb salvage procedures in patients receiving pre- and postoperative chemotherapy for skeletal malignancy.
Adolescent↗
Hemivertebral excision for congenital scoliosis.
We retrospectively reviewed the cases of 10 consecutive patients treated with hemivertebral excision for congenital scoliosis at The Children's Hospital, Denver, CO, between 1982 and 1992. Follow-up consisted of physical and radiographic examination and averaged 54 months (range, 4-111). Age at surgery ranged from 9 months to 10 years, 5 months (average, 3 years, 11 months). Hemivertebra levels were between T12 and L3. The average preoperative curve measured 40 degrees (range, 20-55 degrees); the average at latest follow-up was 16 degrees (range, 3-37 degrees). We found hemivertebral excision for congenital scoliosis to be a safe and effective means of treatment. Curve correction averaged 67% and seemed to be greatest in those less than 4 years of age at the time of surgery.
Child↗
Posttraumatic genu valgum: operative versus nonoperative treatment.
The purpose of this study was to compare the results of operative versus nonoperative treatment for posttraumatic genu valgum. It is a retrospective chart and radiograph review of all patients with the diagnosis of posttraumatic genu valgum from our institution and from data obtained in response to 389 letters sent to the members of the Pediatric Orthopaedic Society of North America (POSNA). The complementary physeal shaft (CPS) angle and the tibial femoral angle (TFA) were measured at the time of injury, at maximal deformity, and at latest follow-up. Fifteen patients were identified, 10 in the nonoperative group and five in the operative group. In both groups, the valgus deformity progressed over a 20-month span. In both groups, the valgus deformity improved at the time of follow-up. There was no significant difference in the CPS angle or TFA, between groups at the time of injury, at maximal deformity, or at follow-up.
Child↗